Electrocardiogram Interpretation: An Exploration of Knowledge and Practice among Secondary Care Hospital's Emergency Physicians

Abstract

Background: An electrocardiogram (ECG) is a simple, easy, low cost and routine diagnostic tool. Nearly all private secondary hospitals of Pakistan have this facility. It is non-invasive, cardiac evaluation test. It has unsophisticated handling procedure. It is very important for duty doctors in their busy clinical practice to have good command on ECG interpretation. Likewise it is prime responsibility of doctors to timely order the ECG when warranted. A good physician has to interpret ECG precisely for timely manage and refer the cardiac related patients to tertiary care facility. Aim and Objectives: The aim of this study was to take a survey among the secondary level private hospital doctors, regarding their knowledge and interpretation skills for timely decision making. Methodology: Total five lethal ECGs were recorded and distributed among 470 doctors, working in the emergency departments of 12 private secondary hospital, of Karachi city, in different shifts from June, 2017 to December, 2017. They were asked to give only one diagnosis with at least five interpretation points to support their diagnosis. The answers were matched with definite diagnosis made by a cardiologist who has more than 15 years experience and currently working as Professor in cardiology. Results: Almost all of the doctors (93%) had readily asked for ordering an ECG for certain epigastric and chest pain evaluation. However, only 30% given the correct diagnosis regarding the lethal cardiac conditions. Interestingly, only 23% rightly interpret the lethal ECGs. Conclusion: According to results shown, the doctors working in private secondary hospitals of Karachi city were good at initiating the ECG recording order. However, ER doctors are advised strongly to gain in depth knowledge and correct interpretation skills as it can save millions of lives in their career.